Posted by Peter on January 14, 2003, at 16:44:30
In reply to Just had pdoc appointment (nm), posted by Peter on January 14, 2003, at 16:03:45
Wierd, my whole message didn't show up. Anyway, this is the outome of my session today: At first, he tried to push more AC's on me (Tegretol-the only one I hadn't tried yet). But I said no way, I'm sick of AC's. So, he gave me 4 AD options: Effexor, Wellbutrin, a TCA, or Strattera. I tried Effexor years ago, but only for a short while, and I was always getting wasted so I never knew if it had a good or bad effect on me. But I do recall hearing a lot about effexor being the hardest to wean off of. Wellbutrin I tried a few years ago for a short stint, but I do remember it making me very agitated. Strattera is too new and I'm no longer comfortable taking brand new meds, I told him-even though he said he's pretty sure they'll market it as an antidepressant down the road. Whatever, I'm not into it now. So it was down to the TCA's, which is good, because the last pdoc I went to for a consultation immediately recommended that I try a TCA because my main problem is not bipolar but depressive-anxiety, and she said TCA's work great for that, especially in those for whom SSRI's don't work well. My doc said the TCA's usually have a lot of antocholinergic (sp?) side-effects, but that they could help me fall asleep if I take them once every night; this would thereby help me to come off the sleeping pills and even lower my klonopin a bit. So we decided on low-dose nortriptyline (Pamelor)(10mg to begin), since he said it probably has the least side-effects in it's class, and it affects serotonin as well as NE, instead of only NE. Desipramine affects only NE, and, though it is great for many, I believe I benefit from something that has some serotonergic activities, since the SSRI's did help me , if only temporarily. As for MAOI's, it was his partner who discovered their efficacy for social anxiety. But he said that, although they are terrific drugs, he doesn't think I'd be comfortable with my neuroses and apprehensions about the dietary cautions, etc. Nortriptyline will not directly help my SP, he said, but it could to the extent that my SP is tied to GAD, which it very well might be-I worry all the time. I hope I made the right choice! Thanks,
Peter
poster:Peter
thread:135759
URL: http://www.dr-bob.org/babble/20030113/msgs/135860.html